Children should get heart exams and EKGs before taking ADHD drugs

Public displays of affection can be embarrassing.

For instance, when we see drug companies getting sweet’n’cozy with mainstream health care organizations as they stroll hand in hand down the road to obscene riches, we sometimes want to shout, “Get a room!”

That’s one of the reasons it’s just so gratifying to see drug companies and mainstream organizations have public spats. (Even though we know they’ll eventually kiss and make up when they devise some new scheme to separate us from our money.)

We had a ringside seat recently for one of those spats when the American Heart Association announced a recommendation that children should receive a thorough heart check up that includes an electrocardiogram (EKG) before taking any ADHD medications.

Most ADHD drugs are stimulants that often increase heart rate and blood pressure. This can result in sudden cardiac arrest in a child with a heart condition. Between 1999 and 2003, almost 20 children taking ADHD drugs died suddenly.

In one random screening of more than 1,000 healthy children, about two percent were found to have an undiagnosed heart problem. About 2.5 million U.S. children take an ADHD drug. Allow me to do the math: As many as 50,000 kids might be at risk.

So what could possibly be the problem with the AHA’s recommendation to take special measures before starting an ADHD drug? It’s the EKG.

If a doctor tells a parent to just go fill a prescription – no problem. But many parents would balk at the inconvenience and extra expense of getting an EKG (along with the realization that ADHD drugs can tax the heart). Bottom line: fewer drug sales.

In an AP article about the AHA recommendation, one drug company rep sounded downright miffed, stating, “There’s no new information here. And frankly, we’re a little perplexed as to the purpose of the American Heart Association coming out with this statement at this time.”

I’m perplexed by the timing too. It should have been done years ago.

Sources:
“CDC: Mounting Illness Reports Linked to Supplement” The Associated Press, 4/18/08, ap.org Heart Exam, EKG Recommended Before Children Get ADHD Drugs” The Associated Press, 4/21/08, ap.org